Pages tagged "Obamacare"

In March, the Obama administration reported on Obamacare’s enrollment numbers. Fewer people have signed up than the administration had hoped, especially among the young and healthy. For many people, even the previously uninsured, the choices in the Obamacare market are simply not what they’re looking for in a health insurance plan.

It’s easy to understand why.

Obamacare replaces a wide variety of market-determined plans with a limited number of plans containing narrow networks of doctors and hospitals and a required set of items covered. No more cheap catastrophic care plan for the young man in his first job. Families and businesses can’t choose an insurance plan that meets their circumstances and needs. Now the government sets the plans and the networks.

The result is that cancer patients are losing access to the doctors and hospitals they rely on. Parents are losing their trusted pediatricians. And families may not have access to the hospital nearest to their homes.

Consider this: In Georgia, one of the five insurers offering plans on the Obamacare exchanges has just one hospital in the entire state in its network. In California and New York, major plans exclude the world-class Cedars-Sinai Hospital in Los Angeles and New York City’s Memorial Sloan-Kettering.

For those with serious and chronic illnesses, there is more terrible news. Many people are finding that their expensive, life-saving medications are not covered under their new Obamacare plans.

Some families do pay less for their monthly premiums for Obamacare-subsidized plans. Many more working families, who earn too much to qualify for subsidized plans, are paying considerably more each month for their health insurance. But the monthly premium is not the only cost in a health insurance plan.

Families are finding that their insurance won’t begin paying for care until they’ve spent $5,000, $10,000, or more of their own money toward the deductible first. And once the deductible is met, the co-insurance (the amount the plan pays) may be as low as 60 percent, leaving individuals to pay the rest of the bill for their care by themselves.

Most plans in the previous insurance market had an “out-of-pocket” cap to prevent people from losing everything in the event of a serious health problem. But in the Obamacare exchanges, some plans are offered with out-of-pocket protection only for care provided in-network. If you go to a doctor or hospital outside of your network, your insurance plan may pay nothing.

People who rely on an expensive medication—for multiple sclerosis, severe rheumatoid arthritis, or HIV for example—are seeing their medication costs skyrocket. If the medication is covered by their insurance plan, they may still have to pay 40 percent of the cost, or thousands of dollars a year, up to the out-of-pocket limit. If the medication is not covered, they must pay the full price and the cost does not count toward the deductible or out-of-pocket maximum. Their expenses then are literally limitless.

One of the most serious problems with Obamacare is that it mistakes health insurance for health care. Obamacare supporters pretend that if every person has a health insurance plan, then they are getting the health care they need. That is simply not true. As we have seen, a plan that doesn’t include your doctor or your medication doesn’t provide the care you need. But there is another serious problem quickly coming into view.

For decades, poor people in this country have been eligible for Medicaid. The amount the government pays doctors to see Medicaid patients, however, is very low. At some point, when a doctor is not getting paid enough to cover the basic expenses of providing care, he or she will stop accepting Medicaid patients, or get out of medicine altogether. That is why today Medicaid patients can wait months for care, if they can find a doctor who will see them at all.

Obamacare specifically expands Medicaid to a wider segment of the population. Young adults with low incomes and the children of low-income families may have Medicaid as their only choice in the Obamacare exchanges, based on family income. So far, enrollment in Medicaid has been more than half of the signups made under the new Obamacare rules. Who will provide care to those people? How long will they have to wait to see a doctor?

In 2008, about 15 percent of Americans were uninsured. The Congressional Budget office projects that under Obamacare, in the years 2013-2023, the percentage of uninsured will never fall below 11 percent of the population. That’s not much of a change in health insurance rates, at the expense of more expensive, less accessible health care for millions more Americans.

One observer who wasted no time beginning to prepare for the 2014 House and Senate elections is President Obama.

Within days of Obama's second inauguration, Democrat sources announced that the President had pledged to hold at least fourteen major fundraising events for his party's congressional candidates. “Maintaining a Democratic majority in the Senate and picking up Democratic seats in the House will be crucial to Obama as he seeks support for his second-term agenda,” a February Associated Press report noted.

Expectations for Democrat gains faltered quickly. Obama was battered by scandals and embarrassed by his erratic handling of a foreign policy crisis in Syria. Republicans were increasingly confident of their hold on the House and determined to make a strong run to take over the Senate.

The 17-day government shutdown in October changed the outlook dramatically. Polls showed a quick 10 percent decline in the share of voters rating the Republican Party positively and a dramatic gain for Democrats on the 'generic ballot' poll question.

More concretely, Democrats showcased striking gains in candidate recruitment, in some cases landing candidates who had rebuffed previous entreaties to run. And Democrats' political committees raked in record fundraising hauls during the shutdown.

Once the shutdown ended, though, the spotlight was on Obamacare - and Democrat prospects have been reeling ever since.

As 2014 begins, Republicans have surged back into the lead on the generic ballot. Democrat recruiting efforts have stalled. Some of the Democrat candidates who announced bids in October had folded their tents altogether by December.

Hopeful Republicans still have a great deal of work to do – especially with respect to fundraising – but the outlook for taking the Senate and bolstering the GOP majority in the House looks better than ever.

Senate

After falling to take the Senate in 2010 and losing seats in 2012, Republicans believe that it's now or never in 2014. Because Democrats made major gains in 2008, there are many more electoral opportunities for Mitch McConnell's team than there are for Harry Reid's.

Ironically, one of the only Republican Senate seats at risk is McConnell's. If the GOP is to retake the Senate, it’s essential that the five-term party leader repel a strong challenge from Kentucky's liberal Secretary of State, 35 year-old Alison Lundergan Grimes.

The other potential GOP trouble spot is Georgia, where the vacancy resulting from two-term Republican Saxby Chambliss's retirement has drawn a large field of Republican candidates that includes three sitting members of the House of Representatives. The winner of an eventual run-off will face off against political newcomer Michelle Nunn, the daughter of the former Senator who held this seat for decades.

Republican opportunities begin with five seats left open by the retirement of veteran Democrat Senators Tim Johnson (SD), Max Baucus (MT), Jay Rockerfeller (WV),Tom Harkin (IA),and Carl Levin (MI). The GOP holds the advantage in the South Dakota, Montana and West Virginia races. And increasingly, Republicans in Iowa and Michigan are convinced they have a chance to 'steal' purple-state seats by challenging Democrat standard-bearers who voted to subject their constituents to Obamacare.

Even if Republicans protect all their own seats and sweep the open seats, though, they'd need to knock off at least one incumbent Democrat Senator to gain a Senate majority. Strong candidates have emerged to take on 'red-state' Democrats Mary Landrieu (LA), Kay Hagan (NC), Mark Begich (AK) and Mark Pryor (AR).

And GOP operatives are maneuvering to corral capable candidates who can take advantage in the increasingly likely event that an anti-Obamacare backlash leads to sustained trouble for 'purple state' Democrats such as Jeanne Shaheen (NH), Mark Udall (CO), Al Franken (MN), and Mark Warner (VA).

House of Representatives

In the House, as many as 90 percent of the seats are so securely within the grasp of one party or the other that there is no prospect of a change in party control.

Of the remainder – the 40 to 45 House seats that will see genuinely competitive races – slightly more are controlled by the Democrats. That means that Democrats would have needed to 'run the table' and then some to take a majority.

Democrats' hopes that the government shutdown would create the 'game-changing' dynamic that could make a Democrat takeover possible have been dashed. A December Washington Post analysis calculated that Nancy Pelosi's squad had a one percent chance of returning to power in 2014.

That said, Democrats have had success in the fundraising battle and expect to make a strong bid for control in 2016. Republicans can take nothing for granted as they prepare for intense battles to dislodge the few remaining Democrats holding on in GOP-leaning districts and to protect GOP stalwarts Democrats have targeted for political elimination.

One observer who wasted no time beginning to prepare for the 2014 House and Senate elections is President Obama.

Within days of Obama's second inauguration, Democrat sources announced that the President had pledged to hold at least fourteen major fundraising events for his party's congressional candidates. “Maintaining a Democratic majority in the Senate and picking up Democratic seats in the House will be crucial to Obama as he seeks support for his second-term agenda,” a February Associated Press report noted.

Expectations for Democrat gains faltered quickly. Obama was battered by scandals and embarrassed by his erratic handling of a foreign policy crisis in Syria. Republicans were increasingly confident of their hold on the House and determined to make a strong run to take over the Senate.

The 17-day government shutdown in October changed the outlook dramatically. Polls showed a quick 10 percent decline in the share of voters rating the Republican Party positively and a dramatic gain for Democrats on the 'generic ballot' poll question.

More concretely, Democrats showcased striking gains in candidate recruitment, in some cases landing candidates who had rebuffed previous entreaties to run. And Democrats' political committees raked in record fundraising hauls during the shutdown.

Once the shutdown ended, though, the spotlight was on Obamacare - and Democrat prospects have been reeling ever since.

As 2014 begins, Republicans have surged back into the lead on the generic ballot. Democrat recruiting efforts have stalled. Some of the Democrat candidates who announced bids in October had folded their tents altogether by December.

Hopeful Republicans still have a great deal of work to do – especially with respect to fundraising – but the outlook for taking the Senate and bolstering the GOP majority in the House looks better than ever.

Senate

After falling to take the Senate in 2010 and losing seats in 2012, Republicans believe that it's now or never in 2014. Because Democrats made major gains in 2008, there are many more electoral opportunities for Mitch McConnell's team than there are for Harry Reid's.

Ironically, one of the only Republican Senate seats at risk is McConnell's. If the GOP is to retake the Senate, it’s essential that the five-term party leader repel a strong challenge from Kentucky's liberal Secretary of State, 35 year-old Alison Lundergan Grimes.

The other potential GOP trouble spot is Georgia, where the vacancy resulting from two-term Republican Saxby Chambliss's retirement has drawn a large field of Republican candidates that includes three sitting members of the House of Representatives. The winner of an eventual run-off will face off against political newcomer Michelle Nunn, the daughter of the former Senator who held this seat for decades.

Republican opportunities begin with five seats left open by the retirement of veteran Democrat Senators Tim Johnson (SD), Max Baucus (MT), Jay Rockerfeller (WV),Tom Harkin (IA),and Carl Levin (MI). The GOP holds the advantage in the South Dakota, Montana and West Virginia races. And increasingly, Republicans in Iowa and Michigan are convinced they have a chance to 'steal' purple-state seats by challenging Democrat standard-bearers who voted to subject their constituents to Obamacare.

Even if Republicans protect all their own seats and sweep the open seats, though, they'd need to knock off at least one incumbent Democrat Senator to gain a Senate majority. Strong candidates have emerged to take on 'red-state' Democrats Mary Landrieu (LA), Kay Hagan (NC), Mark Begich (AK) and Mark Pryor (AR).

And GOP operatives are maneuvering to corral capable candidates who can take advantage in the increasingly likely event that an anti-Obamacare backlash leads to sustained trouble for 'purple state' Democrats such as Jeanne Shaheen (NH), Mark Udall (CO), Al Franken (MN), and Mark Warner (VA).

House of Representatives

In the House, as many as 90 percent of the seats are so securely within the grasp of one party or the other that there is no prospect of a change in party control.

Of the remainder – the 40 to 45 House seats that will see genuinely competitive races – slightly more are controlled by the Democrats. That means that Democrats would have needed to 'run the table' and then some to take a majority.

Democrats' hopes that the government shutdown would create the 'game-changing' dynamic that could make a Democrat takeover possible have been dashed. A December Washington Post analysis calculated that Nancy Pelosi's squad had a one percent chance of returning to power in 2014.

That said, Democrats have had success in the fundraising battle and expect to make a strong bid for control in 2016. Republicans can take nothing for granted as they prepare for intense battles to dislodge the few remaining Democrats holding on in GOP-leaning districts and to protect GOP stalwarts Democrats have targeted for political elimination.

Like one of those Polaroid instant photographs developing slowly in your hand, the details of Obamacare are coming into focus bit by bit. With each week, we learn more about the serious problems that Obamacare is causing for millions of Americans.

First hit were those whose individual insurance plans purchased in the private market did not meet Obamacare’s definition of “comprehensive.” President Obama said that only a small percentage of people would lose their old insurance plans this way. In reality, HHS estimated that 40-67 percent of individual policy owners would lose their coverage.

Next came tens of millions of people employed by small businesses. Their old insurance plans are being cancelled and the new plans have higher premiums, higher deductibles, and narrower provider networks. An estimated half to two-thirds of the people who get their insurance through their employer’s small group plan will have lost their current insurance by 2015.

As Obamacare forces insurance companies to cancel policies and replace them with more expensive alternatives that conform to government criteria, more people are forced out of the private market and into the Obamacare exchanges.

President Obama said that the plans available in the exchanges would be better and more affordable. Under Obamacare, all insurance plans must offer the same basic set of benefits, including maternity care, pediatric benefits, and addiction services. That makes all of the plans more expensive. Many middle class families, who don’t qualify for premium subsidies, will pay more for the plans in the Obamacare exchanges than they were paying before.

There is another side to health care costs that is just coming into focus now, too: high deductibles and high out of pocket costs. Many people choosing new plans from the Obamacare exchanges or from their employer’s offerings are finding that their insurance won’t begin paying for care until they’ve spent $5,000, $10,000, or more of their own money toward the deductible first. And once the deductible is met, the coinsurance (the amount the plan pays) may be as low as 60 percent, leaving the individual to pay the rest of the bill for their care. Most plans today have an “out of pocket” cap to prevent people from losing everything in the event of a serious health problem. But in the exchanges, some plans are offered with out of pocket protection only for care provided in-network. If you go to a doctor or hospital outside of your network, your insurance plan may pay nothing.

The President promised you can keep your doctor, but you might have to pay a lot more to see him or her. To keep costs down, insurers are cutting back their provider networks. People are finding that the doctors and hospitals they rely on are not part of their new network. In Georgia, one of the five insurers offering plans on the exchanges has just one hospital in the entire state in its network. In California and New York, major plans exclude the world-class Cedars-Sinai Hospital in Los Angeles and New York City's Memorial Sloan-Kettering.

These narrower networks mean that millions of people, including those with serious illnesses, will lose access to the pediatricians, family doctors, specialists, and hospitals they trust. So while people with serious illnesses or chronic conditions can indeed buy insurance plans in the exchanges at the same rate as anyone else and cannot be turned away, whether they can keep their doctors as the President promised is a different question.

Many people with serious and chronic illnesses will also be shocked to learn that drug costs are much higher under Obamacare. Lower premium plans have higher out of pocket costs for medications, and insurance may pay as little as 50 percent of drug costs after the higher deductibles are met. The retail price of some medications used to treat cancer, rheumatoid arthritis, HIV and other conditions can be thousands of dollars per month. Patients may pay considerably more for drugs under Obamacare plans than they paid under previous plans.

Low-income individuals and families face a different access issue: the single option available to them on the Obamacare exchanges in many states is Medicaid. In fact, the vast majority of those who have enrolled via the exchanges so far have actually enrolled in Medicaid, not an insurance plan. In many places, doctors are refusing to see new Medicaid patients because of the drastically below-market payments they receive for their services to those patients. Coverage without access is not the good health care uninsured Americans were promised.

One of the most visible signs of trouble with Obamacare was the disastrous rollout of the web site portal that was supposed to make learning about and buying insurance plans in the exchanges as easy as shopping at Amazon.com. While it’s now possible for more people to access the web site, many very serious problems remain. The site still has extremely poor security, endangering the private information of users. The back-end of the site (really the most important part) sends garbled information to the insurance companies for nearly a third of all applications. Medicaid applications are not being sent to state authorities properly. The payment system, where individuals pay their premiums and the government pays the subsidies, hasn’t even been built. Because insurance companies and states have bad data, no payments, and no way to verify information about applicants, a significant percentage of people who think they’ve enrolled in an Obamacare plan or Medicaid will find themselves without insurance coverage on January 1.

As the true picture of Obamacare becomes clearer, Americans are responding with some of the lowest approval ratings the President and his health care plan have seen to date, notably among women and younger voters, key Democrat constituencies. Most Americans, according to recent Gallup polls, believe that Obamacare should be repealed or scaled back. An AP/GfK poll showed that nearly half of those with employer-provided insurance said their plan was changing and getting more expensive – and three-quarters of those said it was because of Obamacare. As the truth about Obamacare become clearer, it will be Democrats at the ballot box next year that really feel the pain.

Matthew Brooks is the executive director of the Republican Jewish Coalition. This article was published in the Washington Jewish Week, December 26, 2013.

Like one of those Polaroid instant photographs developing slowly in your hand, the details of Obamacare are coming into focus bit by bit. With each week, we learn more about the serious problems that Obamacare is causing for millions of Americans.

First hit were those whose individual insurance plans purchased in the private market did not meet Obamacare’s definition of “comprehensive.” President Obama said that only a small percentage of people would lose their old insurance plans this way. In reality, HHS estimated that 40-67 percent of individual policy owners would lose their coverage.

Next came tens of millions of people employed by small businesses. Their old insurance plans are being cancelled and the new plans have higher premiums, higher deductibles, and narrower provider networks. An estimated half to two-thirds of the people who get their insurance through their employer’s small group plan will have lost their current insurance by 2015.

As Obamacare forces insurance companies to cancel policies and replace them with more expensive alternatives that conform to government criteria, more people are forced out of the private market and into the Obamacare exchanges.

President Obama said that the plans available in the exchanges would be better and more affordable. Under Obamacare, all insurance plans must offer the same basic set of benefits, including maternity care, pediatric benefits, and addiction services. That makes all of the plans more expensive. Many middle class families, who don’t qualify for premium subsidies, will pay more for the plans in the Obamacare exchanges than they were paying before.

There is another side to health care costs that is just coming into focus now, too: high deductibles and high out of pocket costs. Many people choosing new plans from the Obamacare exchanges or from their employer’s offerings are finding that their insurance won’t begin paying for care until they’ve spent $5,000, $10,000, or more of their own money toward the deductible first. And once the deductible is met, the coinsurance (the amount the plan pays) may be as low as 60 percent, leaving the individual to pay the rest of the bill for their care. Most plans today have an “out of pocket” cap to prevent people from losing everything in the event of a serious health problem. But in the exchanges, some plans are offered with out of pocket protection only for care provided in-network. If you go to a doctor or hospital outside of your network, your insurance plan may pay nothing.

The President promised you can keep your doctor, but you might have to pay a lot more to see him or her. To keep costs down, insurers are cutting back their provider networks. People are finding that the doctors and hospitals they rely on are not part of their new network. In Georgia, one of the five insurers offering plans on the exchanges has just one hospital in the entire state in its network. In California and New York, major plans exclude the world-class Cedars-Sinai Hospital in Los Angeles and New York City's Memorial Sloan-Kettering.

These narrower networks mean that millions of people, including those with serious illnesses, will lose access to the pediatricians, family doctors, specialists, and hospitals they trust. So while people with serious illnesses or chronic conditions can indeed buy insurance plans in the exchanges at the same rate as anyone else and cannot be turned away, whether they can keep their doctors as the President promised is a different question.

Many people with serious and chronic illnesses will also be shocked to learn that drug costs are much higher under Obamacare. Lower premium plans have higher out of pocket costs for medications, and insurance may pay as little as 50 percent of drug costs after the higher deductibles are met. The retail price of some medications used to treat cancer, rheumatoid arthritis, HIV and other conditions can be thousands of dollars per month. Patients may pay considerably more for drugs under Obamacare plans than they paid under previous plans.

Low-income individuals and families face a different access issue: the single option available to them on the Obamacare exchanges in many states is Medicaid. In fact, the vast majority of those who have enrolled via the exchanges so far have actually enrolled in Medicaid, not an insurance plan. In many places, doctors are refusing to see new Medicaid patients because of the drastically below-market payments they receive for their services to those patients. Coverage without access is not the good health care uninsured Americans were promised.

One of the most visible signs of trouble with Obamacare was the disastrous rollout of the web site portal that was supposed to make learning about and buying insurance plans in the exchanges as easy as shopping at Amazon.com. While it’s now possible for more people to access the web site, many very serious problems remain. The site still has extremely poor security, endangering the private information of users. The back-end of the site (really the most important part) sends garbled information to the insurance companies for nearly a third of all applications. Medicaid applications are not being sent to state authorities properly. The payment system, where individuals pay their premiums and the government pays the subsidies, hasn’t even been built. Because insurance companies and states have bad data, no payments, and no way to verify information about applicants, a significant percentage of people who think they’ve enrolled in an Obamacare plan or Medicaid will find themselves without insurance coverage on January 1.

As the true picture of Obamacare becomes clearer, Americans are responding with some of the lowest approval ratings the President and his health care plan have seen to date, notably among women and younger voters, key Democrat constituencies. Most Americans, according to recent Gallup polls, believe that Obamacare should be repealed or scaled back. An AP/GfK poll showed that nearly half of those with employer-provided insurance said their plan was changing and getting more expensive – and three-quarters of those said it was because of Obamacare. As the truth about Obamacare become clearer, it will be Democrats at the ballot box next year that really feel the pain.

Matthew Brooks is the executive director of the Republican Jewish Coalition. This article was published in the Washington Jewish Week, December 26, 2013.

President Obama’s health care law goes into effect on January 1, 2014. The state exchanges where individuals would be able research and purchase health insurance plans are scheduled to be in place by October 1. But it seems certain that important elements of the law won’t be ready for on time, creating a PR nightmare for Democrats before the 2014 elections.

Many provisions of the law appear headed for serious problems or have already been set aside as unworkable in the existing time frame.

Around the July 4 holiday this year, the administration announced that the employer mandate would be postponed until January 2015. That has given employers with 50 or more employees a reprieve from the requirement to provide health insurance to employees or pay a $2000 per employee fine. The confusion and high costs associated with the mandate made implementing it on schedule impossible.The President unilaterally set aside one major pillar of the law, with no legislative authority to do so.

At around the same time, it was reported that the Department of Health and Human Services (HHS) would not require states to verify the income of people who apply for a government subsidy to obtain insurance in the states’ exchanges. Systems could not be put in place fast enough to do the verifications, so millions of dollars in subsidies will be distributed on an “honor system” basis. The potential for fraud is enormous, with no way to compare income tax or other data with the applications for subsidies.

Another basic element of the law has been delayed until 2015: the consumer cost cap intended to protect consumers from sky-high deductibles or out of pocket limits. Actually, that provision was set aside in February; the public only heard about it in July.

The very sophisticated information technology needed to coordinate data between state and federal agencies and to operate the state insurance exchanges is a vital element in the Obamacare roll-out, and it’s nowhere near ready. Since February, administration officials have been reassuring Congress and the public that the technology for the state exchanges would be in place and secure by October 1. But in June, the HHS Inspector General issued a report showing that firewall and other security testing is behind schedule and may take place only days before the exchanges are set to open. The report also raises the possibility that the exchanges will open without appropriate user verification protocols, meaning that users would be open to identity theft and other abuse of their personal information.

It was not an encouraging sign last month when the web site to answer consumers’ questions about Obamacare went live and then crashed 2 hours later.

The human element of getting people signed up for the state exchanges opens up other serious security concerns. HHS has been forced to cut back the training of Obamacare “navigators” by 33 percent and background checks and other security processes in hiring these counselors will not be complete when the exchanges open. At the same time, HHS posted a notice in the beginning of August, looking for vendors to provide translation services for the exchanges. The government wants translators to support over 100 languages, as mandated in the law. The contractors must not only be trained in health care and health insurance terminology, but they will be trusted to maintain the security of the confidential personal information they will be handling.

Uncertainty about how and when Obamacare’s provisions would be implemented has already given rise to negative effects for the economy and for health care. For example, some major insurers have refused to join state exchanges and even stopped doing business in some states in order to avoid them. In California, Anthem Blue Cross, United Health Care and Aetna have pulled out. The second largest insurer in South Carolina has left the state. Aetna has also pulled out of Maryland.

Anxiety about the employer mandate has caused many businesses to reduce workers’ hours and hire fewer new workers to avoid Obamacare’s requirements and penalties. In addition to fast-food chains and small businesses, state and local governments have reduced staff and cut work hours. Adjunct professors in community colleges, local school district employees, city seasonal and part-time workers, and many others have seen their hours cut to prevent the $2000 per employee penalty from kicking in.

When October 1 rolls around, a huge, nation-wide system for purchasing health insurance and managing health care for every American will begin operations. President Obama’s claims about affordable insurance, greater fairness in the distribution of health care, and an improved economy will be put to the test.

This article appeared in the July-August 2013 issue of the RJC Bulletin. The Bulletin is sent to contributing RJC members 6 times a year. To renew/upgrade your membership and receive the Bulletin, click here.

President Obama’s health care law goes into effect on January 1, 2014. The state exchanges where individuals would be able research and purchase health insurance plans are scheduled to be in place by October 1. But it seems certain that important elements of the law won’t be ready for on time, creating a PR nightmare for Democrats before the 2014 elections.

Many provisions of the law appear headed for serious problems or have already been set aside as unworkable in the existing time frame.

Around the July 4 holiday this year, the administration announced that the employer mandate would be postponed until January 2015. That has given employers with 50 or more employees a reprieve from the requirement to provide health insurance to employees or pay a $2000 per employee fine. The confusion and high costs associated with the mandate made implementing it on schedule impossible.The President unilaterally set aside one major pillar of the law, with no legislative authority to do so.

At around the same time, it was reported that the Department of Health and Human Services (HHS) would not require states to verify the income of people who apply for a government subsidy to obtain insurance in the states’ exchanges. Systems could not be put in place fast enough to do the verifications, so millions of dollars in subsidies will be distributed on an “honor system” basis. The potential for fraud is enormous, with no way to compare income tax or other data with the applications for subsidies.

Another basic element of the law has been delayed until 2015: the consumer cost cap intended to protect consumers from sky-high deductibles or out of pocket limits. Actually, that provision was set aside in February; the public only heard about it in July.

The very sophisticated information technology needed to coordinate data between state and federal agencies and to operate the state insurance exchanges is a vital element in the Obamacare roll-out, and it’s nowhere near ready. Since February, administration officials have been reassuring Congress and the public that the technology for the state exchanges would be in place and secure by October 1. But in June, the HHS Inspector General issued a report showing that firewall and other security testing is behind schedule and may take place only days before the exchanges are set to open. The report also raises the possibility that the exchanges will open without appropriate user verification protocols, meaning that users would be open to identity theft and other abuse of their personal information.

It was not an encouraging sign last month when the web site to answer consumers’ questions about Obamacare went live and then crashed 2 hours later.

The human element of getting people signed up for the state exchanges opens up other serious security concerns. HHS has been forced to cut back the training of Obamacare “navigators” by 33 percent and background checks and other security processes in hiring these counselors will not be complete when the exchanges open. At the same time, HHS posted a notice in the beginning of August, looking for vendors to provide translation services for the exchanges. The government wants translators to support over 100 languages, as mandated in the law. The contractors must not only be trained in health care and health insurance terminology, but they will be trusted to maintain the security of the confidential personal information they will be handling.

Uncertainty about how and when Obamacare’s provisions would be implemented has already given rise to negative effects for the economy and for health care. For example, some major insurers have refused to join state exchanges and even stopped doing business in some states in order to avoid them. In California, Anthem Blue Cross, United Health Care and Aetna have pulled out. The second largest insurer in South Carolina has left the state. Aetna has also pulled out of Maryland.

Anxiety about the employer mandate has caused many businesses to reduce workers’ hours and hire fewer new workers to avoid Obamacare’s requirements and penalties. In addition to fast-food chains and small businesses, state and local governments have reduced staff and cut work hours. Adjunct professors in community colleges, local school district employees, city seasonal and part-time workers, and many others have seen their hours cut to prevent the $2000 per employee penalty from kicking in.

When October 1 rolls around, a huge, nation-wide system for purchasing health insurance and managing health care for every American will begin operations. President Obama’s claims about affordable insurance, greater fairness in the distribution of health care, and an improved economy will be put to the test.

This article appeared in the July-August 2013 issue of the RJC Bulletin. The Bulletin is sent to contributing RJC members 6 times a year. To renew/upgrade your membership and receive the Bulletin, click here.

As Will Rogers said, “When you find yourself in a hole, stop digging!" In the last four years, the Obama administration has dug our country deeper and deeper into several painful and dangerous holes. It's time to stop digging and find better solutions.

Pres. Obama's economic policies have eroded the earning power of the middle class and mired us in the slowest-growing post-recession economy in decades. A wave of new taxes will hit working families in January. Billions of taxpayer dollars were wasted on a useless "stimulus" and "green" companies that went bankrupt. To date, Pres. Obama has added nearly $6 trillion to the national debt since taking office.

Meanwhile, unemployment stood above 8 percent for 43 straight months during Pres. Obama's tenure. Companies aren't hiring – in large part because of the uncertainty and poor prospects created by heavy-handed government regulations and a chaotic tax environment.

Mitt Romney has a better solution. By lowering tax rates across the board, while eliminating deductions and loopholes for high-end earners, we can broaden the tax base and bring in more revenue without raising taxes on the middle class. Responsible bipartisan efforts to cut non-security spending and reform the tax code, along with opening up more energy resources on this continent, will spur economic growth and cut the deficit. Lower corporate tax rates and more sensible regulations will make it possible for new businesses to start and for established businesses to grow.

Another hole is being dug by the rising costs of health care and the looming bankruptcy of Medicare and Social Security. Obamacare is already adding to the cost of health care for families and many employers have said they may have to drop their employee insurance plans under its restrictions. We will have to slash entitlement benefits and raise taxes to punishing levels if we don't get a handle on how Medicare and Social Security are structured.

The answer to these problems lies in allowing increased competition to bring down costs, while providing a secure safety net for those in need. Mitt Romney wants to repeal and replace Obamacare with a free-market system that protects people with preexisting conditions and the poor. His plan for Medicare reform shields everyone age 55 and older from any changes to the system and will keep traditional Medicare available for those younger workers who choose it. That will strengthen Medicare and offer the same benefits at lower cost to today's younger workers when they reach retirement age.

In foreign policy, Pres. Obama has pursued a naïve and dangerous policy that has given our enemies new openings to harm us, as in Benghazi, Libya. Pres. Obama's mixed messages and inaction during the Arab Spring have allowed Islamist forces to gain ground in several countries. He was silent during the 2010 freedom demonstrations in Iran and his response to the civil war in Syria has not advanced freedom, peace, or U.S. interests in the region.

Mitt Romney proposes a principled policy that puts America's national interests first and that projects American diplomatic, economic, and if absolutely necessary, military strength to protect those interests. Romney understands that we must stand with our allies and continue the fight against the radical Islamists who threaten our security and our democratic values.

The U.S.-Israel alliance has been badly hurt by the antipathy Pres. Obama has shown to Israel and her leaders. The military cooperation mandated by our pro-Israel Congress is strong, but the level of trust and cooperation between the two governments is low. Pres. Obama's made the "1967 borders" and Israeli construction freezes starting points for negotiations, which reinforced Palestinian intransigence and made peace between Israel and the Palestinians even more elusive.

Mitt Romney will stand with Israel, knowing that Israel is our best ally and an important partner with the U.S., and understanding that strong strategic, economic, and moral ties bind the two countries.

One of the most dangerous threats to American national security today is the possibility of a nuclear Iran. Congress supported sanctions on Iran (sometimes over the President's objection) but the diplomatic effort to support those sanctions has been weak and ineffectual. That is why Russia and China have routinely stymied efforts to create a truly effective international sanctions regime that might deter the Iranians. A nuclear Iran would be an existential threat to Israel, a destabilizing force in the Middle East, and a clear threat to America's interests and those of our European and Asian allies. The President's policies have given Iran almost four years to continue enriching uranium; they now approach the quantity and quality needed to create nuclear weapons.

Mitt Romney is committed to stopping Iran from acquiring the capability to build nuclear weapons. Our national security, and the security of our most important allies around the globe, depends on a strong U.S. policy toward Iran.

The American people face a significant choice in just a few days' time: a choice between a government-run, top-down economy and a free-market, opportunity economy; a choice between the weakness that invites attacks and the strength to keep our country secure; and a choice between leaving our children a country that we have built and enriched with freedom and ingenuity, or leaving them a country shackled in debt and diminished in scope. It's not too late to stop digging holes and start building our country again.

As Will Rogers said, “When you find yourself in a hole, stop digging!" In the last four years, the Obama administration has dug our country deeper and deeper into several painful and dangerous holes. It's time to stop digging and find better solutions.

Pres. Obama's economic policies have eroded the earning power of the middle class and mired us in the slowest-growing post-recession economy in decades. A wave of new taxes will hit working families in January. Billions of taxpayer dollars were wasted on a useless "stimulus" and "green" companies that went bankrupt. To date, Pres. Obama has added nearly $6 trillion to the national debt since taking office.

Meanwhile, unemployment stood above 8 percent for 43 straight months during Pres. Obama's tenure. Companies aren't hiring – in large part because of the uncertainty and poor prospects created by heavy-handed government regulations and a chaotic tax environment.

Mitt Romney has a better solution. By lowering tax rates across the board, while eliminating deductions and loopholes for high-end earners, we can broaden the tax base and bring in more revenue without raising taxes on the middle class. Responsible bipartisan efforts to cut non-security spending and reform the tax code, along with opening up more energy resources on this continent, will spur economic growth and cut the deficit. Lower corporate tax rates and more sensible regulations will make it possible for new businesses to start and for established businesses to grow.

Another hole is being dug by the rising costs of health care and the looming bankruptcy of Medicare and Social Security. Obamacare is already adding to the cost of health care for families and many employers have said they may have to drop their employee insurance plans under its restrictions. We will have to slash entitlement benefits and raise taxes to punishing levels if we don't get a handle on how Medicare and Social Security are structured.

The answer to these problems lies in allowing increased competition to bring down costs, while providing a secure safety net for those in need. Mitt Romney wants to repeal and replace Obamacare with a free-market system that protects people with preexisting conditions and the poor. His plan for Medicare reform shields everyone age 55 and older from any changes to the system and will keep traditional Medicare available for those younger workers who choose it. That will strengthen Medicare and offer the same benefits at lower cost to today's younger workers when they reach retirement age.

In foreign policy, Pres. Obama has pursued a naïve and dangerous policy that has given our enemies new openings to harm us, as in Benghazi, Libya. Pres. Obama's mixed messages and inaction during the Arab Spring have allowed Islamist forces to gain ground in several countries. He was silent during the 2010 freedom demonstrations in Iran and his response to the civil war in Syria has not advanced freedom, peace, or U.S. interests in the region.

Mitt Romney proposes a principled policy that puts America's national interests first and that projects American diplomatic, economic, and if absolutely necessary, military strength to protect those interests. Romney understands that we must stand with our allies and continue the fight against the radical Islamists who threaten our security and our democratic values.

The U.S.-Israel alliance has been badly hurt by the antipathy Pres. Obama has shown to Israel and her leaders. The military cooperation mandated by our pro-Israel Congress is strong, but the level of trust and cooperation between the two governments is low. Pres. Obama's made the "1967 borders" and Israeli construction freezes starting points for negotiations, which reinforced Palestinian intransigence and made peace between Israel and the Palestinians even more elusive.

Mitt Romney will stand with Israel, knowing that Israel is our best ally and an important partner with the U.S., and understanding that strong strategic, economic, and moral ties bind the two countries.

One of the most dangerous threats to American national security today is the possibility of a nuclear Iran. Congress supported sanctions on Iran (sometimes over the President's objection) but the diplomatic effort to support those sanctions has been weak and ineffectual. That is why Russia and China have routinely stymied efforts to create a truly effective international sanctions regime that might deter the Iranians. A nuclear Iran would be an existential threat to Israel, a destabilizing force in the Middle East, and a clear threat to America's interests and those of our European and Asian allies. The President's policies have given Iran almost four years to continue enriching uranium; they now approach the quantity and quality needed to create nuclear weapons.

Mitt Romney is committed to stopping Iran from acquiring the capability to build nuclear weapons. Our national security, and the security of our most important allies around the globe, depends on a strong U.S. policy toward Iran.

The American people face a significant choice in just a few days' time: a choice between a government-run, top-down economy and a free-market, opportunity economy; a choice between the weakness that invites attacks and the strength to keep our country secure; and a choice between leaving our children a country that we have built and enriched with freedom and ingenuity, or leaving them a country shackled in debt and diminished in scope. It's not too late to stop digging holes and start building our country again.

The term “Imperial Presidency” became popular in the 1960s, and served as the title of a 1973 volume by historian Arthur M. Schlesinger, Jr. to describe the modern presidency of the United States. Schlesinger’s argument was that the Presidency and the Executive Branch had grown entirely out of control and that all constitutional limits on Executive Power had been lost. His real target, of course, was the Nixon Administration.

Leftist opponents of George W. Bush resurrected the “imperial Presidency” charge, claiming that the Bush Administration had slipped the constraints of constitutional limits with respect to its war-making authority in Iraq. As one critic wrote in a July, 2007 New York Times op-ed: “Given how intent the president is on expanding his authority, it is startling to recall how the Constitution’s framers viewed presidential power. They were revolutionaries who detested kings, and their great concern when they established the United States was that they not accidentally create a kingdom. To guard against it, they sharply limited presidential authority, which Edmund Randolph, a Constitutional Convention delegate and the first attorney general, called ‘the foetus of monarchy.’” Yet, for the most part, the Bush Administration was appropriately deferential to Congress and the courts, and the left’s “imperial Presidency” claims lacked substantial foundation.

The mantle of an imperial Presidency, however, sticks tightly to Barak Obama. In truth, the Obama Presidency has been absolutely Nixonian in its disregard for constitutional limits and uniquely disrespectful for the authority of Congress and the judiciary. Here are only a few examples:

President Obama has attacked the authority and legitimacy of the Supreme Court in a manner and fashion without parallel in the post-war period. Opposed to an expansive definition of free speech, Obama took the unprecedented step of criticizing the Supreme Court during a State of the Union address. Then, when it became clear that the Court had serious doubts regarding the constitutionality of the Administration’s signature health care bill, the Administration launched a concerted and calculated effort to influence the Court by threatening to undermine its basic legitimacy. To begin with, the Administration needed unprecedented and corrosive procedural gamesmanship by Congressional leaders to enact Obamacare. Then, the President publicly warned the Court, in the midst of deliberations, that it “would be an unprecedented, extraordinary step” to find the law unconstitutional and influential political voices began urging the President to run a tough political campaign against the Court if Obamacare was overturned.

In February 2011, Mr. Obama directed the Justice Department to stop defending the Defense of Marriage Act, which bars federal recognition of same-sex marriages, against constitutional challenges. DOMA was and remains a valid statutory enactment by the Congress.

The Administration "cooked" the auto bailout to benefit political supporters at the expense of statutorily protected bondholders without changing existing law. In the years leading up to the economic crisis, Chrysler had been unable to acquire routine financing and so had been forced to turn to so-called secured debt in order to fund its operations. Secured debt takes first priority in payment; it is also typically preserved during bankruptcy under what is referred to as the "absolute priority" rule — since the lender of secured debt offers a loan to a troubled borrower only because he is guaranteed first repayment when the loan is up. In the Chrysler case, however, creditors who held the company's secured bonds were steamrolled into accepting 29 cents on the dollar for their loans. Meanwhile, the underfunded and unsecured pension plans of the politically connected United Auto Workers were paid more than 40 cents on the dollar. This was unprecedented.

After the Employee Free Choice Act—designed to bolster labor unions’ dwindling membership rolls—was defeated by Congress, the National Labor Relations Board announced a rule that would implement "snap elections" for union representation, limiting employers’ abilities to make their case to workers and virtually guaranteeing a higher rate of unionization at the expense of workplace democracy. This was quickly struck down by the courts.

After an Internet regulation proposal failed to make it through Congress, the Federal Communications Commission announced that it would regulate the Web by order. This has been challenged in court.

According to Politico, the Administration appointed at least 30 "czars to formulate and implement policy. Only five of these were subject to Congressional confirmation. None of the czars for "green jobs," "climate change," executive payments, healthcare, energy and environment, and science were vetted by Congress. Congress moved to rein the Administration in through its budget authority. However, President Obama in his signing statement regarding H.R. 1473, the FY 2011 Budget Bill, stated that section 2262 of H.R. 1473, which bars the expenditure of funds for four named White House staff positions, would be ignored.

The Administration has repeatedly bypassed Congress, using executive orders, agency guidance and collusive lawsuit settlements, to implement environmental regulations. Specific examples are greenhouse gas regulation, expansion of Clean Water Act jurisdiction, chemical regulations, regulation of Chesapeake Bay stormwater runoff, reconsideration of national ambient air quality standards (NAAQS) for ozone, reversal of the California Waiver, retroactive veto of Arch Coal’s Clean Water Act permit for Spruce Mine No. 1, and overriding West Virginia’s water permitting authority to further burden the coal industry. The administration’s fuel economy standards, which can be viewed as the regulatory equivalent of declaring war on carmakers, were invoked without Congressional involvement, in a clear departure from past precedent when Congress has set the standards and the EPA has implemented them. This time, the EPA is doing both.

Reed Rubinstein is a shareholder in the Washington, D.C. office of Dinsmore & Shohl LLP and a member of the RJC's Leadership Council. The views expressed here are solely his own.